CMS eyes new payment model for behavioral health

The Centers for Medicare & Medicaid Services is interested in developing a behavioral health payment model, but wants feedback from providers and the community.

The model is meant to improve healthcare quality and access and lower the cost of care for Medicare, Medicaid or Children’s Health Insurance Program patients who have behavioral health conditions.

CMS announced its intentions for the new model in a notice (PDF) for a public meeting in the Federal Register. The agency will hold an all-day public meeting to discuss ideas for the model beginning at 10 a.m. EST on Friday, Sept. 8 at the CMS Central Office in Baltimore.

The Center for Medicare and Medicaid Innovation Center will test the new payment and service delivery model, which aims to address the needs of patients who have substance use disorders, mental disorders in the presence of co-occurring conditions, Alzheimer’s disease and related dementia and behavioral health workforce challenges.

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The federal government under the Obama administration helped to accelerate the shift to value-based payments with a goal to tie 30% of all Medicare fee-for-service payments to alternative payment models (APMs) by the end of 2016 and a 50% goal by 2018.

Although the Department of Health and Human Services met its 30% target by March of 2016, it was unclear whether the new White House administration would embrace value-based care. In recent months CMS delayed the start of new bundled payment programs and the expansion of others to January.

But in the Federal Register notice CMS said it wants stakeholders to come to the meeting with ideas for potential models.

The meeting will feature four panel sessions of behavioral health experts who will discuss behavioral health disorders. Attendees are invited to listen to the panelists’ experiences delivering care and their ideas for payment models. Attendees will be able to ask questions to the panels and make brief individual statements (two minutes per models).

The agency said the recommendations made during the meeting will help design a model test to address behavioral payment and service delivery. Those interested in attending the meeting must register online at​resources/​behavioral-health-paymentcare-summit.html by 12:00 a.m. EST on Aug. 25.